[1]崔传举,王玉香,燕　燕,等.脑苷肌肽联合尤瑞克林治疗急性脑梗死疗效观察[J].新乡医学院学报,2022,39(7):659-663.[doi:10.7683/xxyxyxb.2022.07.012]
　CUI Chuanju,WANG Yuxiang,YAN Yan,et al.Effect of cerebroside carnosine combined with urinary kallidinogenase in the treatment of acute cerebral infarction[J].Journal of Xinxiang Medical University,2022,39(7):659-663.[doi:10.7683/xxyxyxb.2022.07.012]
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脑苷肌肽联合尤瑞克林治疗急性脑梗死疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年7
页码:
659-663
栏目:
临床研究
出版日期:
2022-07-05

文章信息/Info

Title:
Effect of cerebroside carnosine combined with urinary kallidinogenase in the treatment of acute cerebral infarction
作者:
崔传举; 王玉香; 燕　燕; 李艾帆
（郑州市第一人民医院神经内科，河南　郑州　450000）
Author(s):
CUI Chuanju; WANG Yuxiang; YAN Yan; LI Aifan
(Department of Neurology,Zhengzhou First People′s Hospital,Zhengzhou 450000,Henan Province,China)
关键词:
急性脑梗死; 脑苷肌肽; 尤瑞克林
Keywords:
acute cerebral infarction;  cerebroside carnosine;  urinary kallidinogenase
分类号:
R197.39
DOI:
10.7683/xxyxyxb.2022.07.012
文献标志码:
A
摘要:
目的　探讨脑苷肌肽联合尤瑞克林治疗急性脑梗死（ACI）的临床效果。方法　选择2018年10月至2020年4月郑州市第一人民医院收治的118例ACI患者为研究对象，按照治疗方法将患者分为观察组（n=74）和对照组（n=44）。所有患者给予监测血糖和血压、清除自由基、改善脑线粒体代谢、抗血小板聚集等常规治疗措施，在常规治疗基础上，对照组患者给予尤瑞克林注射液治疗，观察组患者给予脑苷肌肽和尤瑞克林注射联合治疗，2组患者均治疗2周。治疗前和治疗后，使用经颅彩色多普勒超声测定患者大脑中动脉血流参数，包括阻力指数（RI）、平均血流速度（Vm）、搏动指数（PI）；检测患者血清氧化应激指标谷胱甘肽过氧化物酶（GSH-Px）、丙二醛（MDA）及炎症因子白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）和趋化因子12（CXCL12）、长链非编码RNA（lncRNA）CAI2水平；采用美国国立卫生研究所卒中量表（NIHSS）评估患者的神经功能缺损程度，采用日常生活能力（ADL）量表评估患者的日常生活能力。治疗2周后评估2组患者的临床疗效。结果　2组患者治疗前大脑中动脉RI、PI、Vm比较差异无统计学意义（P>0.05）；与治疗前比较，2组患者治疗后大脑中动脉RI与PI显著降低，Vm显著升高（P<0.05）；治疗后，观察组患者大脑中动脉RI与PI显著低于对照组，Vm显著高于对照组（P<0.05）。2组患者治疗前血清GSH-Px、MDA、IL-8、TNF-α、CXCL12水平及lncRNA CAI2相对表达量比较差异无统计学意义（P>0.05）；与治疗前比较，2组患者治疗后血清GSH-Px水平显著升高，血清MDA、IL-8、TNF-α、CXCL12水平及lncRNA CAI2相对表达量显著降低（P<0.05）；治疗后，观察组患者血清GSH-Px水平显著高于对照组，血清MDA、IL-8、TNF-α、CXCL12水平及lncRNA CAI2相对表达量显著低于对照组（P<0.05）。2组患者治疗前NIHSS和ADL评分比较差异无统计学意义（P>0.05）；与治疗前比较，2组患者治疗后NIHSS评分显著降低，ADL评分显著升高（P<0.05）；治疗后，观察组患者NIHSS评分显著低于对照组，ADL评分显著高于对照组（P<0.05）。观察组和对照组患者治疗总有效率分别为91.24%（69/74）、76.3%（33/44），观察组患者治疗总有效率显著高于对照组（χ2=7.835，P<0.05）。结论　脑苷肌肽联合尤瑞克林治疗可以显著改善ACI患者的氧化应激、炎症反应和脑血流状态，减轻神经功能缺损，提高ADL。
Abstract:
Objective　To investigate the clinical effect of cerebroside carnosine combined with urinary kallidinogenase in the treatment of acute cerebral infarction (ACI).Methods　A total of 118 ACI patients admitted to Zhengzhou First People′s Hospital from October 2018 to April 2020 were selected as the research subjects,and the patients were divided into observation group (n=74) and control group (n=44) according to the treatment method.All patients were given routine treatment measures such as monitoring blood sugar and blood pressure,scavenging free radicals,improving brain mitochondrial metabolism and anti-platelet aggregation.On the basis of routine treatment,the patients in the control group were treated with urinary kallidinogenase injection,while the patients in the observation group were treated with cerebroside carnosine combined with urinary kallidinogenase injection.All patients were treated for two weeks.Before and after treatment,the blood flow parameters of the middle cerebral artery were measured by transcranial color Doppler ultrasound,including resistance index (RI),mean velocity (Vm) and pulsatility index (PI).The levels of serum oxidative stress indexes including glutathione peroxidase (GSH-Px),malondialdehyde (MDA) and inflammatory factors including interleukin-8 (IL-8),tumor necrosis factor-α(TNF-α) and C-X-C chemokine ligand 12 (CXCL12),long non-coding RNA (lncRNA) CAI2 were detected.The degree of neurological deficit of patients was evaluated by the National Institutes of Health stroke scale (NIHSS),and the activity of daily living (ADL) of patients was evaluated by ADL scale.The clinical effect of patients in the two groups was evaluated after two weeks of treatment.Results　There was no significant difference in the RI,PI and Vm of the middle cerebral artery of patients between the two groups before treatment (P>0.05).Compared with before treatment,the RI and PI of the middle cerebral artery of patients after treatment were significantly decreased,and the Vm was significantly increased in the two groups (P<0.05).After treatment,the RI and PI of the middle cerebral artery of patients in the observation group were significantly lower than those in the control group,and the Vm was significantly higher than that in the control group (P<0.05).There was no significant difference in the levels of serum GSH-Px,MDA,IL-8,TNF-α,CXCL12 and the relative expression level of lncRNA CAI2 of patients between the two groups before treatment (P>0.05).Compared with before treatment,the levels of serum GSH-Px of patients after treatment were significantly increased,and the levels of serum MDA,IL-8,TNF-α,CXCL12 and the relative expression level of lncRNA CAI2 were significantly decreased in the two groups (P<0.05).After treatment,the level of serum GSH-Px of patients in the observation group was significantly higher than those in the control group,and the levels of serum MDA,IL-8,TNF-α,CXCL12 and the relative expression level of lncRNA CAI2 were significantly lower than those in the control group (P<0.05).There was no significant difference in NIHSS and ADL scores of patients between the two groups before treatment (P>0.05).Compared with before treatment,the NIHSS scores of patients in the two groups after treatment were significantly decreased,and the ADL scores were significantly increased (P<0.05).After treatment,the NIHSS score of patients in the observation group was significantly lower than that in the control group,and the ADL score was significantly higher than that in the control group (P<0.05).The total effective rate of patients in the observation group and control group was 91.24% (69/74) and 76.3% (33/44),respectively.The total effective rate in the observation group was significantly higher than that in the control group (χ2=7.835,P<0.05).Conclusion　The treatment of cerebroside carnosine combined with urinary kallidinogenase can significantly improve the oxidative stress,inflammatory response and cerebral blood flow,reduce neurologic impairment,and increase the ADL of ACI patients.

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更新日期/Last Update: 2022-07-05